<tr><td ><div class="lightblue">Account info</div></td></tr>
<tr><td><hr size="4" class="login"></td></tr>
<tr><td class="textlogin" style="font-size:10pt;left-pedding:20;">Note: Fields marked with asterick (<font color="red">*</font>) are obligatory</td></tr>
<tr><td><div class="darkblue">Personal information</div></td></tr>
<tr ><td ><table width="100%">
<tr ><td class="textlogin" width="35%"><font color="red">*</font>First name:</td><td align="right"><input class="login" value="{$firstname}" type="text" name="firstname" size="65" displayname="First name"/></td></tr>
<tr><td class="textlogin"><font color="red">*</font>Last name:</td><td align="right"><input class="login" type="text" value="{$lastname}" name="lastname" size="65" displayname="Last name"/></td></tr>
<tr><td class="textlogin"><font color="red">*</font>Email:</td><td align="right"><input class="login" value="{$email}" type="text" name="email" size="65" displayname="Email"/></td></tr>
<tr><td class="textlogin">&nbsp;Age</td><td align="right"><input class="login" value="{$age}" type="text" name="age" size="65" /></td></tr>
</table></td></tr>

<tr style=><td><div class="darkblue">Address</div></td></tr>
<tr style=><td><table width="100%">
<tr><td class="textlogin" width="35%">Address1:</td><td width="65%" colspan="3" align="right"><input class="login" value="{$address1}" type="text" name="address1" size="65"/></td></tr>
<tr><td class="textlogin" width="35%">Address2:</td><td colspan="3" align="right"><input class="login" type="text" value="{$address1}" name="address2" size="65"/></td></tr>
<tr><td class="textlogin">City:</td><td><input class="login" type="text" name="city" value="{$city}" size="24"/></td>
<td class="textlogin" width="18%" style="padding-left:20;">&nbsp;Home phone:</td><td align="right"><input class="login" type="text" name="home_phone" size="16" value="{$home_phone}" displayname="Home phone"/></td></tr>
<tr><td class="textlogin">Country:</td><td><input class="login" type="text" name="country" size="18" displayname="Country" value="{$country}"/></td>
<td class="textlogin"  style="padding-left:20;">&nbsp;Work phone:</td><td align="right"><input class="login" type="text" name="work_phone" size="16" value="{$work_phone}" displayname="Work phone"/></td></tr>
<tr><td class="textlogin">State:</td>
<td><select  name="state" id="state" style="width:136"></select>


</td></tr>
<tr><td class="textlogin">Zip:</td><td><input class="login" type="text" name="zip" size="18"  displayname="Zip" value="{$zip}"/></td></tr>
</table></td></tr>

<tr ><td><div class="darkblue">Login information</div></td></tr>
<tr ><td ><table width="100%">
<tr><td class="textlogin" width="29%"><label for="login" runat="server"><font color="red">*</font>Username:</LABEL></td>
<td align="left"><input size="20" class="login" type="text" name="login" displayname="Username" value="{$login}"/></td></tr>
</table></td></tr>

<tr><td><input type="submit" name="update" value="Update account info">
<input type="submit" name="retrieve" value="Retrieve saved info"></td></tr>
<tr><td><hr size="4" class="login"></td></tr>